Employment Application

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Golden Eagle Transportation, Inc. is an equal opportunity employer, dedicated to a policy of Non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does Not prohibit performance of essential job functions.
Your Last Name: *
Your First Name: *
Your Middle Initial:
Present Address Line 1: *
Present Address Line 2:
City: *
State: *
ZIP Code: *
Permanent Address Line 1:
Permanent Address Line 2:
City:
State:
ZIP Code:
Social Security Number: *
How long at this address: (years/months)
Are you at least 18 years of age: Yes No
   
Home Phone:
Cell Phone: *
E-mail Address: *
Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, green card, etc.) within 3 days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.
Do you have any relatives who are presently (or have formerly been), employed by Golden Eagle? Yes No
If Yes, please list them below:
Is there any information we would need about your name or use of another name, for us to be able to check your work record? Please specify:
How did you learn about us?
If you heard about us through a referral, please let us kNow the name of the person who referred us to you:
Have you ever been convicted of a felony? Yes No
If Yes, please explain:
EDUCATIONAL HISTORY:  
High School:
College:
Technical Training:
Other:
EMPLOYMENT RECORD:  
Please provide us with commercial business references that you have worked with. You should include companies that you have had an affiliation within the past 5 years:
Name of Business:
Position Held:
Address of Company:
Month and Year Affiliation Began:
Month and Year Affiliation Ended:
Manager/Supervisor:
Phone Number: (Include area code)
Wage/Salary:
Reason for leaving:
Business Reference 2:  
Name of Business:
Position Held:
Address of Company:
Month and Year Affiliation Began:
Month and Year Affiliation Ended:
Manager/Supervisor:
Phone Number: (Include area code)
Wage/Salary:
Reason for leaving:
Business Reference 3:  
Name of Business:
Position Held:
Address of Company:
Month and Year Affiliation Began:
Month and Year Affiliation Ended:
Manager/Supervisor:
Phone Number: (Include area code)
Wage/Salary:
Reason for leaving:
NoTE:  We will contact every employer on this profile.  Please enter any employer that you do NoT wish us to contact and the reason for the exclusion.
Employer's Name:
Reason:
Employer's Name:
Reason:

REFERENCES:		 Please do Not include relatives or former employers.
First And Last Name:
Years Known:
Nature of Relationship:
Occupation:
Telephone Number: (Include area code)
REFERENCE 2:  
First And Last Name:
Years Known:
Nature of Relationship:
Occupation:
Telephone Number: (Include area code)
REFERENCE 3:  
First And Last Name:
Years Known:
Nature of Relationship:
Occupation:
Telephone Number: (Include area code)
WORK AVAILABILITY*:  
When would you be available to start?
Are you flexible to work evenings and/or weekends? Yes No
Can you work overtime without prior Notice? Yes No
Can you work from home, if needed? Yes No
Are you looking for a career or a temporary position? Career Temp
Do you mind working varying hours throughout a workweek? Yes No
Shift availability:
POSITION*:  
Are you seeking an administrative position? Yes No
Do you work best alone or on a team? Alone Team
Are you attentive, deliberate, and thorough when following specific instructions? Yes No
Are you neat, organized, and timely? Yes No
Do you mind working longer hours on any given day provided how busy the office is? Yes No
Can you remember to perform routine tasks without fail? (Daily, weekly, bi-weekly, monthly, or quarterly) Yes No
Have you ever worked as a secretary or personal assistant to an executive officer? Yes No
SALARY/HOURLY RATE*:    
Is there a salary requirement?  Yes No
If so, how much?  $ per
*Fields are required
*Optional until requested by Golden Eagle Transportation, Inc. to continue hiring process.
ACKNOWLEDGEMENT AND AUTHORIZATION:
I ackNowledge that the information contained herein is correct to the best of my kNowledge and that any misrepresentation of material may be cause of termination of my contract, if hired. I am providing Golden Eagle Transportation, Inc. with authorization to check my references and background information.  I give consent to call, write, or otherwise communicate with persons or companies listed above and to investigate using public or other sources as deemed necessary by Golden Eagle Transportation, Inc. to verify such information.
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